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Blue Cross NCCommercial · Coverage · Medical Policy · NC · Family Medicine, Internal Medicine, OB-GYN +3 moreMedium impact

Medical Policy Update for December 5, 2023

Act
immediately
Effective date
Dec 5, 2023
Identified
Jun 16, 2026

Summary

Blue Cross NC updated multiple medical policies effective December 5, 2023, with significant changes to genetic testing coverage, laboratory testing criteria, and billing codes. Key changes include expanded BRCA genetic testing beyond just BRCA 1/2 genes, new coverage criteria for celiac disease monitoring, updated cervical cancer screening guidelines, and removal of coverage for routine cervical screening under age 21.

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What to do

immediately · 4 steps
01Billing team must update system with new CPT codes for genetic testing (81432, 81433, 81479, 0102U, 0103U, 0129U) and laboratory tests (0393U, 83880, 88172, 88173, 88177, 81403, 87563).
02Update encounter forms to reflect expanded BRCA testing coverage beyond just BRCA 1/2 genes.
03Remove billing for cervical cancer screening for patients under 21 unless specific high-risk criteria are met.
04Update celiac disease testing protocols to include new monitoring intervals for IgA sufficient/deficient patients.

Codes mentioned

838808817288173881778143281433814798140387563

Original notice

Medical Policy Update for December 5, 2023
bluecrossnc.com · Always check the source before changing claims.
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Related changes

See all Blue Cross NC changes →
Medical Policy Update for May 15, 2024HighEffective May 15, 2024 · Medical PolicyMedical Policy Update for December 30, 2022HighEffective Jan 1, 2023 · Medical PolicyMedical Policy Update for April 1, 2025MediumEffective Apr 1, 2025 · Medical PolicyMedical Policy Update for July 1, 2025MediumEffective Jul 1, 2025 · Medical PolicyBrowse every Blue Cross NC change in the policy list

Related policy hubs

Blue Cross NC policiesNC policy changesFamily MedicineInternal MedicineOB-GYNOncologyGastroenterologyGeneral PracticeCode 83880Code 88172Code 88173Code 88177Code 81432Code 81433Code 81479Code 81403Code 87563

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